You are the nurse evaluating a newly admitted patients laboratory results, which include several values that are outside of reference ranges. Which of the following would cause the release of antidiuretic hormone (ADH)?

Correct Answer: A

Rationale: The correct answer is A: Increased serum sodium. High serum sodium levels trigger the release of antidiuretic hormone (ADH) from the pituitary gland to help retain water in the body and maintain fluid balance. This is a physiological response to prevent further dehydration. Decreased serum potassium (choice B), decreased hemoglobin (choice C), and increased platelets (choice D) do not directly stimulate the release of ADH. Hence, they are incorrect choices in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Metabolic alkalosis. Pyloric stenosis can lead to vomiting, causing loss of gastric acid and chloride ions, leading to metabolic alkalosis. Low potassium levels are common in metabolic alkalosis due to potassium shifting into cells to compensate for the alkalosis. Hypercalcemia (choice A) is not associated with pyloric stenosis. Metabolic acidosis (choice B) typically presents with low pH and bicarbonate levels. Respiratory acidosis (choice D) is caused by impaired gas exchange in the lungs, not related to pyloric stenosis.

Correct Answer: A

Rationale: The correct answer is A: "Avoid carrying your grandchild with the arm that has the central catheter." This is important because carrying a child can put strain on the arm where the catheter is inserted, increasing the risk of dislodging or damaging the catheter. It is crucial to protect the integrity of the catheter site to prevent complications such as infection or bleeding. Choice B is incorrect because placing the arm with the central catheter in a sling during the day is unnecessary and could restrict the client's mobility and lead to discomfort. Choice C is incorrect because flushing the PICC line with normal saline should be done by a healthcare professional and not the client themselves. Choice D is incorrect because using the arm with the central catheter for most activities of daily living can increase the risk of accidental dislodgment or damage to the catheter. It is important to be cautious and limit certain activities to protect the catheter and maintain its function.

Correct Answer: D

Rationale: The correct answer is D: Presence of an ulnar pulse. This is the most important assessment to complete first because the presence of an ulnar pulse indicates adequate circulation in the hand, ensuring that the radial artery catheter is not compromising blood flow. If the ulnar pulse is absent, it may signify impaired circulation and potential complications such as ischemia. Choice A is incorrect because the amount of pressure in the fluid container is not directly related to the assessment of the radial artery catheter. Choice B is incorrect because the date of catheter tubing change is important for infection control but not the immediate priority in this situation. Choice C is incorrect as the percent of heparin in the infusion container is important for anticoagulation therapy but does not take precedence over assessing circulation in the hand.

Correct Answer: B

Rationale: The correct answer is B: Ensure an x-ray is completed to confirm placement. This is crucial to prevent complications such as pneumothorax or incorrect placement. X-ray confirmation is the gold standard to verify the central line's proper positioning before initiating any infusions. Option A is incorrect because starting the infusion without confirming placement can lead to serious complications. Option C is unnecessary for central line insertion. Option D is important but not the immediate next step as confirming placement takes precedence for patient safety.

Correct Answer: A

Rationale: The correct answer is A: Substantially reduced renal function. In older adults, elevated serum creatinine levels can indicate impaired kidney function, as the kidneys may not filter waste products as efficiently. This can lead to a buildup of creatinine in the blood. Acute kidney injury (Choice B) is a sudden decline in kidney function and would typically present with a more significant increase in creatinine levels. Decreased cardiac output (Choice C) would not directly cause elevated creatinine levels. Alterations in the ratio of body fluids to muscle mass (Choice D) would not be a common cause of elevated creatinine levels in this scenario.

Correct Answer: C

Rationale: Correct Answer: C Rationale: 1. Choice C is correct because it emphasizes the importance of cleaning connections before accessing the device to prevent infection. 2. Sterile technique during insertion cannot guarantee no risk of infection (Choice B). 3. Wearing a sling is unnecessary for a central vascular access device (Choice A). 4. The statement about not being able to take a bath is not accurate and is not a common restriction (Choice D).

Correct Answer: A

Rationale: The correct answer is A because intravenous D5W is a hypotonic solution that can lead to dilutional hyponatremia. D5W does not contain sodium, so it can cause a decrease in serum sodium levels. Clients on NPO status receiving D5W are at higher risk due to lack of sodium intake. Choices B, C, and D are incorrect because they do not directly contribute to hyponatremia. Sulfonamide antibiotics, ibuprofen, and digoxin are not typically associated with causing hyponatremia. Therefore, assessing the client on NPO status receiving D5W for potential hyponatremia is the priority.

Correct Answer: A

Rationale: Step 1: High magnesium levels can lead to hypermagnesemia, which can cause decreased neuromuscular function. Step 2: Diminished deep tendon reflexes are a sign of neuromuscular impairment, indicating potential hypermagnesemia. Step 3: Assessing for diminished deep tendon reflexes is crucial to monitor neuromuscular function in patients with high magnesium levels. Summary: A is correct because hypermagnesemia affects neuromuscular function. B, C, and D are incorrect as they do not directly relate to the effects of high magnesium levels.